Abstract 11190: The Prognostic Impact of Lack of Chest Pain in Young Patients With Acute Coronary Syndromes
Objectives: Although lack of chest pain on presentation with acute coronary syndromes (ACS) has been associated with poor outcomes; yet there is limited literature examining the outcomes of ACS without chest pain in young adults. The aim of the current study was to examine that in a multicenter multinational ACS registry from the Middle East.
Methods: Retrospective analysis of 7,930 consecutive patients with ACS enrolled in the Second Gulf Registry Of Acute Coronary Events. A cohort of 3933 patients in the age group 55 years and younger were selected of whom 552 were women (14%). Multivariate logistic regression was applied to see adjusted risk ratio for in-hospital and one-year mortality.
Results: There were 255 patients (6.5%) without chest pain in the age group 55 years and younger. The mortality rates were significantly higher in patients who lacked chest pain compared to patients with chest pain (In-Hospital mortality = 10.2% versus 1.8%, p= 0.001, and 1-year mortality = 17.4% versus 6.2%, p= 0.001). Covariates independently associated with lack of chest pain were; higher Killip class on presentation (OR, 6.45 [95%CI, 4.8-8.56]; P = 0.001), tachycardia (OR, 3.42 [95%CI, 2.57-4.57]; P = 0.001), and chronic renal impairment (OR, 2.0 [95%CI, 1.02-4.57]; P = 0.04) [table1]. Presentation without chest pain was an independent predictor of in-hospital mortality (OR, 5.68 [95%CI, 3.41-9.47]; P = 0.001), and one-year mortality (OR, 2.86 [95%CI, 1.90-4.35]; P = 0.001) [table 2].
Conclusions: Our study demonstrates that lack of chest pain was an independent predictor of mortality in young patient hospitalized with ACS, even after accounting for other comorbidities.
Author Disclosures: A.M. Salam: None. K.F. AlHabib: None. W. Almahmeed: None. A. Alsheikh-Ali: Other Research Support; Modest; Medtronic, Behringer Ingelheim. Honoraria; Modest; Boehringer Ingelheim, Bayer, Pfizer. K. Sulaiman: None. H. Amin: None. J. Al-Lawati: None. A. Al-Motarreb: None. N. Asaad: None. R. Singh: None. J. Al Suwaidi: None.
- © 2014 by American Heart Association, Inc.